Leyden Academy on Vitality and Ageing, Poortgebouw LUMC, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.
Int Psychogeriatr. 2013 Aug;25(8):1267-74. doi: 10.1017/S1041610212002281. Epub 2013 Jan 7.
The role of individual characteristics in incidences of elder abuse has long been highest on research and policy agendas. Now, it is timely to discuss factors that go beyond victim and perpetrator. Environmental factors also play an important role in elder abuse. In this paper, we address the framing of elder abuse as a social and health problem. Attention is paid to the factors that influence societal context and the healthcare system, its organization, structure, and principles.
Focus groups and in-depth semi-structured interviews were held with different professionals and older people themselves. Qualitative analysis of focus groups and interviews transcripts was performed to analyze how different professional groups and older persons themselves view elder abuse, to determine opinions and attitudes toward elder abuse and the necessary actions that should be taken to prevent or intervene in the problem.
Two main explanatory frameworks emerged in the discourse of older persons and care professionals: social arrangements and healthcare system. The themes within the social arrangements included social taboo, social control and responsibility, and institutional cultures. The fragmentation of care and changes in the financing of healthcare were two aspects distinguished within the framework of the healthcare system.
Two explanatory frameworks showed elder abuse as both a social and health problem. The environmental factors through social arrangements and healthcare system have an influence on framing of abuse. The different ways of framing abuse impact the understanding of abuse, ways of intervention, and prevention measures.
个体特征在虐待老人事件中的作用一直是研究和政策议程的重点。现在，讨论超越受害者和施害者的因素是适时的。环境因素在虐待老人事件中也起着重要作用。在本文中，我们将虐待老人问题作为一个社会和健康问题来讨论。我们关注影响社会环境和医疗保健系统的因素，包括其组织、结构和原则。
我们与不同的专业人员和老年人本人进行了焦点小组和深入的半结构化访谈。对焦点小组和访谈记录进行了定性分析，以分析不同专业群体和老年人本人如何看待虐待老人问题，确定对虐待老人问题的看法和态度，以及为预防或干预该问题而应采取的必要行动。
老年人和护理专业人员的话语中出现了两个主要的解释框架：社会安排和医疗保健系统。社会安排中的主题包括社会禁忌、社会控制和责任以及机构文化。在医疗保健系统框架内，区分了护理的碎片化和医疗保健融资的变化。
两个解释框架将虐待老人问题视为一个社会和健康问题。通过社会安排和医疗保健系统的环境因素对虐待的形成产生影响。虐待的不同表述方式影响对虐待的理解、干预方式和预防措施。
